Padding material for surgical casts



y 1960 P. A. HOMIER ET L 2,935,065

PADDING MATERIAL FOR SURGICALCASTS Filed Nov. 12, 1954 INVENT Rs P904 4 om/se ATTORNEY PADDING MATERIAL FOR SURGICAL CASTS Paul A. Homier, Nixon, and Rolland G. Litchfield, New Brunswick, NJ., assignors to Johnson & Johnson, a corporation of New Jersey Application November 12, 1954, Serial No. 468,368 7 Claims. (Cl. 128--91) This invention relates to padding used beneath orthopedic casts such as plaster of Paris immobilizing casts.

Plaster of Paris casts are ordinarily applied to the patient by immersing a roll of bandage material in water to saturate it thoroughly, squeezing out the excess water, and then rolling in spiral fashion the bandage on the arm, leg, joint or other portion of the body to. be immobilized, overlapping the various layers until a cast of the desired thickness has been built up. The bandage is then allowed to set for a predetermined time necessary to permit the cast to acquire the desired strength. Application of the plaster of Paris band-age directly to the skin has caused abrasion, particularly to bony prominences. This has given rise to use of padding material between the cast and the skin. However, use of water-repellent padding, which has been common, undesirably restricts escape of moisture, such as perspiration, from the skin. Further, water-absorbent padding tends to become saturated with plaster of Paris and thereby in effect become a part of the cast, giving rise again to the varied disadvantages which were sought to be overcome originally.

Objects and advantages of the invention include provision of a barrier between the plaster of Paris cast and the body of the patient without the inherent deleterious properties of prior art paddings.

. Preferred objects and advantages of the invention include provision of orthopedic padding which will stretch laterally, i.e. in the cross direction, without disintegrating, thereby to make the bandage more conformable to bony prominences.

The invention bandage is a web of soft material, preferably nonwoven sheeting, of properties described below, placed adjacent the skin and between the skin and a plaster of Paris cast (or other immobilizing liquidactivated cast), and in contact with substantially the whole areaof skin covered by the cast. The properties of the invention band-age which account for its outstanding advantages include a liquid-repellent surface in contact with the cast and a water-absorbent surface adjacent the skin. The bandage thereby absorbs perspiration and any exudate given off by the body, and affords a soft protective surface against the skin, minimizing chafing while still protecting the skin and the soft absorbent layer from the moisture and plaster of Paris of the bandage.

The invention may be readily understood by reference to the attached drawings and the ensuing description.

Fig. 1 illustrates application of the invention padding material to the fore-arm preparatory to applying plaster of Paris roller bandage.

Fig. 2 shows the completed cast, part of which is broken away to show the lining of the invention.

Fig. 3 is a transverse section taken on plane 3-3 of Fig. 2.

Fig. 4 illustrates in greater detail the construction of padding material according to a preferred embodiment of the invention.

The padding of the invention may be any material having desired softness, thickness and strength so that it 2,935,065 Pate ted. May 3, 1960 maybe built up into a protective liner beneath the plaster of Paris cast. Thickness such that four plies thereof are about 0.140 inch thick has been found satisfactory. Weight may be about 1100 grams per square yard. The padding may be formed from a multiplicity of superposed card webs, suitably several card webs of absorbent fibers, such as cotton or rayon, on the absorbent side of the padding, and several card webs of nonabsorbent fibers, such as nonabsorbent cotton or other fibers treated with water-repellent agent. The combined card webs are slit into strips of desired width in the direction of the length of the card webs, i.e. the dominant fiber direction.

One method of rendering fibers water-repellent is to spray them with an aqueous emulsion of parafiin wax or other suitable water repellent, the emulsion also containing emulsifying agent when necessary. Such a spraying operation may be carried out eitherafter the web is assembled or on the unassembled fibers before the padding is made.

Procedures for making the invention padding which afford notable advantages from the standpoint of the end product are described in United States Patents 2,039,312 and 2,407,548. According to these procedures, several card webs of cotton or other textile fiber are superimposed on each other, several on one side of the sheet being absorbent and several (preferably at least two) on the other side being water-repellent, as described above. The composite sheet is then wet out with a dilute (about 0.1% by weight) aqueous solution of polyvinyl alcohol or other agent such as methyl cellulose, starch, or carboxymethyl cellulose to impart a light bond and coherency, particularly to the water-repellent fibersf Excess solution is pressed out between squeeze rolls. The amount of polyvinyl alcohol thereby deposited on the fiber is'sufi'icient to impart coherency to the sheet, particularly the water-repellent fibers, without substantially restraining or ironing down the projecting fibers on each surface. This amount is about 0.1% to 0.5% based on the weight of dry fibers, most suitably about 0.2%. The polyvinyl alcohol treated material is passed through the nip between two rollers, one of which is engraved with a design consisting of intermittent recesses. Preferably, the design is formed of regularly spaced small doughnuts located on parallel diagonal lines. Each doughnut is a circular recess having an unrecessed circular center. Other designs may be used, however, e.g. parallel wavy lines, diamond prints, diagonal intersecting lines, etc. An aqueous emulsion of polyvinyl resin binder having about 25% resin is deposited in the recesses of the engraved roll and is thereafter printed on the absorbent surface of the composite sheet according to the design appearing on the roll. Preferably, most of the resin remains on the surface rather than penetrating the sheet. 'ghe sheet printed according to this procedure is then ried.

The completed material 10, shown in Fig. 4, contains fibers generally oriented in the longitudinal direction, as card webs normally are. The sheet is intermittently bonded in areas 11 each of which is in the shape of a small doughnut having a ring 12 and an unbonded hole 15. In the longitudinal direction the fibers are under tension and hence the fabric has maximum strength. When the sheet is stretched laterally, the fibers tend to separate but the spacing of bonded areas 11 is such that the general arrangement of the fibers is preserved, thereby restricting substantially the disintegration of the sheet. After drying, the sheet is characterized by the appearance of a large number of projecting fibers on the surface.

Although one method of preparing the padding of the present invention has been described, the scope of the invention is not limited thereto. Continuous bonding rather than intermittent bonding of a sheet of fibers may be utilized to preserve coherence. Instead of employing card webs, the padding may be formed of non-oriented fibers, i.e. isotropic webs. For example, absorbent fibers may be entangled with each other by mercerization, without use of a binder, and one surface of the web thereafter sprayed to render it water-repellent.

Referring to Fig. 1, a roll 16 of the padding material is applied to the affected member, such as the arm 14 shown, using the overlapping spiral technique. The undersurface 17 adjacent the arm is water-absorbent, while the exterior surface 18 is water-repellent. If desired, sev eral layers of padding may be used. I

After the padding is in place, the plaster of Paris bandage may be applied, also using conventional spiral wrapping technique. The completed plaster of Paris cast is indicated at 20. It will be noted that the padding was placed so as to protect substantially the entire area of skin 'to be covered by plaster of Paris bandage. In Fig. 3, the relative positions of padding 10, absorbent surface 17, water-repellent surface 18, arm 14 and plaster of Paris cast 20 are clearly shown. It is apparent that the absorbent surface 17 adjacent the arm serves to permit escape of perspiration or body exudates from the surface of the skin. Further, repellent surface i8 protects the soft padding from penetration by water and/or plaster of Paris which would subsequently harden, thereby rendering the soft, protective padding hard and non-pro tective.

Although several specific embodiments of the invention have been described and illustrated herein, it is intended that the scope of protection not be limited thereto, but include modifications and equivalents within the spirit and teaching of the invention as defined by the claims.

The claims are:

1. A surgical support adapted to contact a human body member, comprising an orthopedic-immobilizing wateractivated cast and soft sheet-like padding, said padding being adapted to contact the skin of said member, and the surface of said padding which contacts the skin being 4 absorbent and the surface thereof which contacts said cast being water repellent.

2. A support of claim 1 in which the padding is formed of spirally wound and overlapped strip material.

3. A support of claim 2 wherein the padding is formed of a multiplicity of water-absorbent carded cotton fibers superposed by a multiplicity of Water-repellent carded cotton fibers and said padding is bonded to provide substantial strength transverse to the dominant fiber direction.

4. A support of claim 3 wherein the bonding is in the form of doughnuts regularly spaced from each other to permit lateral stretching of said sheet without disrupting the general fiber to fiber relationship in the sheet.

5. A support of claim 1 in which the padding is a multiplicity of superposed textile fiber card webs intermittently bonded with an adhesive to permit extensibility transverse to the dominant fiber orientation without disintegration of said sheet, and containing sufiicient amount of an over-all second bonding agent to impart coherence to said repellent surface, the amount of said second agent being insufficient to restrain substantially projecting fiber ends on either side of said sheet.

OTHER REFERENCES The Journal of Bone and Joint Surgery for February 1950, vol. 32B, pp. 62-65. (Copy in Scientific Library.) 

